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Wang Z, White DL, Hoogeveen R, Chen L, Whitsel EA, Richardson PA, Virani SS, Garcia JM, El-Serag HB, Jiao L. Anti-Hypertensive Medication Use, Soluble Receptor for Glycation End Products and Risk of Pancreatic Cancer in the Women's Health Initiative Study. Journal of clinical medicine. 2018 Aug 2; 7(8).
Pancreatic cancer is the fourth leading cause of cancer death. Soluble receptor for glycation end products (sRAGE), which is modulated by anti-hypertensive (HT) medications, has been inversely associated with pancreatic cancer. However, the association between commonly used anti-HT medications and risk of pancreatic cancer is unknown. A total of 145,551 postmenopausal women from the Women Health Initiative (WHI) Study were included in analysis. Use of angiotensin converting enzyme inhibitors (ACEi), -blockers, calcium channel blockers (CCBs) and diuretics was ascertained at baseline (1993 1998). Baseline sRAGE levels were measured among a subset of 2104 participants using an immunoassay. Multivariable Cox proportional hazard regression model was performed to estimate hazard ratios (HRs) and its 95% confidence intervals (CIs) for pancreatic cancer in association with anti-HT medications. Increased risk of pancreatic cancer was found among users of short-acting CCB (HR = 1.66, 95% CI: 1.20 2.28) and long-term ( 3 years) users of short-acting CCB (HR = 2.07, 95% CI: 1.42 3.02) compared to users of other anti-HT medications. Average sRAGE levels were lower in short-acting CCB users than users of other anti-HT medications (1173 versus 1454 pg/mL, = 0.038). Non-statistically significant reduced risk of pancreatic cancer was found among users of -blockers (HR = 0.80, 95% CI: 0.60 1.07). Average sRAGE levels were higher in -blockers users than users of other anti-HT medications (1692 versus 1454 pg/mL, > 0.05). Future studies are warranted to confirm these findings and elucidate potential mechanisms by which anti-HT medications influence development of pancreatic cancer.